Pilates in pregnancy

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What is pilates?

Pilates trains your body to be strong, flexible and balanced. It involves a series of movements and positions that help to improve your strength and coordination. Deep breathing and relaxation are important in controlling how you do the exercises (Latey 2001, Levine et al 2007, Anderson & Spector 2000, Segal et al 2004).

The movements focus on your tummy, pelvic floor muscles and back muscles, which are all key to good posture, balance and strength. They also help your back and pelvis to be supported.

If you strengthen your muscles, you’ll develop a stable core. Pilates builds on this strength through a series of controlled, increasingly challenging movements that won’t put your body under strain.

How can pilates help me in pregnancy?

Pilates strengthens your tummy, back and pelvic floor muscles without straining other joints, so it's a great exercise to do when you're pregnant.
Some research suggests that doing pilates regularly can be as effective as doing pelvic floor exercises.

Check that your pilates instructor is experienced and trained in teaching pregnant women, and try to choose a pilates class that's for pregnant women (ACPWH 2010).

The main benefit of pilates is that it targets the exact muscles and functions that can be a problem during pregnancy and after birth, in a safe way.

Doing regular pilates will help to:

Strengthen your tummy muscles, which equips your body better to cope with the strains caused by the weight of your growing baby. Hormones make the tissues (ligaments) that connect your bones more pliable in pregnancy, making you more prone to injury (Kristiansson et al 1996).

Reduces back pain, by exercising the deepest tummy muscles that stabilise your back and pelvis (Endleman et al 2008). Weak muscles can lead to back or pelvic pain (Aladro-Gonzalvo et al 2013, Tlapáková et al 2011).

Strengthen your pelvic floor, which will help to support your bowel, bladder and uterus (womb) as your baby grows and moves down. This may prevent you from leaking small amounts of wee when you cough or sneeze.

Helps with balance, as you may feel a little more clumsy, or that your balance isn’t as good as usual(Pruett & Caputo 2011), in pregnancy. Pilates exercises strengthen your core (Johnson et al 2007) and may make you more stable when you walk as your bump grows.

Takes the strain off your back and pelvis, by using positions such as going on your hands and knees, which is a great position for pregnancy. Towards the end of your pregnancy, it may also help to get your baby into the right position for birth.

Relax and control your breathing, which is important for pregnancy and labour (ACPWH 2010).

Exercise is good for you during pregnancy. You should aim to do both aerobic exercise, such as brisk walking or swimming, and muscle-strengthening exercise, such as pilates or yoga (Wright 2010, Zavorsky 2011).

What if I haven’t done pilates before?

Before trying pilates, make sure that you can find your pelvic floor muscles. If you can do a good pelvic floor contraction, you'll get more from your pilates sessions. If you can't find or feel them, ask to see a physiotherapist before starting pilates.

Try the following exercise to see how good your core stability is. You may have to try it a few times before you get the hang of it:

Get on to your hands and knees. Align your hands under your shoulders, and your knees under your hips. Keep your back flat. Try to do it next to a mirror, so you can check your position.

Breathe in, and then as you breathe out, squeeze your pelvic floor muscles. At the same time, pull your belly button in and up.

Try to hold this for 10 seconds. Continue breathing normally throughout the squeeze, and keep your back still.

Relax your muscles slowly at the end of the exercise.

If you can perform this exercise easily, and repeat it 10 times, your pelvic floor and core tummy muscles are working well. This exercise is safe to perform at any stage of your pregnancy.

Can I attend any pilates classes?

Look for a class that is for pregnant women (ACPWH 2010). If your instructor isn't a health professional, check that she has a qualification in teaching exercise to pregnant women.

Even if you can do pelvic floor exercises with ease, you may find that many ordinary pilates classes go too quickly for you. If there isn’t an antenatal pilates class in your area, make sure your instructor knows that you’re pregnant, and how many weeks you are. She’ll need to adapt the exercises for you.

If you're in any pain or discomfort at any time, stop what you are doing and let your midwife or doctor know before returning to your classes.

Be cautious about the following:

Positions that involve lying on your tummy or back, or standing on one leg, in mid-pregnancy and beyond. A good instructor will suggest alterative, safe postures.

Don't stretch any joint to its full range, especially in an unsupported position. This is because the hormone relaxin will have made your ligaments looser.

Supporting your weight on your hands and knees may make your wrists ache. This can be particularly uncomfortable if you have carpal tunnel syndrome. Your instructor should show you how to lean forward on an exercise ball, if this is the case.

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